Individual provider Active NPI

Deisy Palomar

  • Skilled Nursing Facility
  • Elgin, IL
National Provider Identifier
1073970299
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
160.006897 Issued in IL
Practice address
788 Hiawatha Dr
Elgin, IL 60120-3126
Phone
(224) 402-8276
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 160.006897 IL Primary

Addresses

Primary practice location

788 Hiawatha Dr
Elgin, IL 60120-3126

Mailing address

788 Hiawatha Dr
Elgin, IL 60120-3126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160.006897ILMDSkilled Nursing Facility

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1073970299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 HIAWATHA DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 HIAWATHA DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203126",
            "telephone_number": "224-402-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMAR",
        "first_name": "DEISY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "160.006897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.